Vascular

Vascular assessment asks a practical question: is tissue receiving enough arterial inflow and venous drainage to remain viable? Arterial disease reduces oxygen delivery. Venous disease raises venous pressure, causing dependent edema, skin inflammation, and impaired wound healing. Thrombosis can obstruct venous return or embolize. An aneurysm may remain silent until rupture becomes catastrophic. Lower-extremity peripheral artery disease (PAD) is usually caused by atherosclerotic narrowing or occlusion. Distal to a stenosis, perfusion pressure falls. During exertion, working muscle demands more oxygen than the narrowed arterial supply can deliver, producing claudication. As disease progresses, perfusion may become inadequate even at rest, leading to rest pain, ulceration, gangrene, or chronic limb-threatening ischemia (CLTI). Classify the presentation before focusing on the test result: - Asymptomatic PAD may be identified through an abnormal pulse examination or vascular testing. - Chronic symptomatic PAD commonly causes reproducible exertional calf, thigh, or buttock discomfort that settles with rest. - CLTI presents with ischemic rest pain, non-healing ulceration, or gangrene and requires urgent vascular assessment. - Acute limb ischemia (ALI) is a sudden reduction in limb perfusion over days...